1. a. Every individual and group hospital service corporation contract that provides hospital
or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant
to P.L.1938, c.366 (C.17:48-1 et seq.), or approved for issuance or renewal in this State by the
Commissioner of Banking and Insurance, on or after the effective date of this act shall provide
coverage for biologically-based mental illness under the same terms and conditions as provided
for any other sickness under the contract. "Biologically-based mental illness" means a mental
or nervous condition that is caused by a biological disorder of the brain and results in a
clinically significant or psychological syndrome or pattern that substantially limits the
functioning of the person with the illness, including but not limited to, schizophrenia,
schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other
psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental
disorder or autism."Same terms and conditions" means that the hospital service corporation
cannot apply different copayments, deductibles or benefit limits to biologically-based mental
health benefits than those applied to other medical or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which a hospital
service corporation determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the hospital service corporation; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the contract.

c. The provisions of this section shall apply to all contracts in which the hospital service
corporation has reserved the right to change the premium.

2. a. Every individual and group medical service corporation contract that provides hospital
or medical expense benefits that is delivered, issued, executed or renewed in this State pursuant
to P.L.1940, c.74 (C.17:48A-1 et seq.), or approved for issuance or renewal in this State by the
Commissioner of Banking and Insurance, on or after the effective date of this act shall provide
coverage for biologically-based mental illness under the same terms and conditions as provided
for any other sickness under the contract. "Biologically-based mental illness" means a mental
or nervous condition that is caused by a biological disorder of the brain and results in a
clinically significant or psychological syndrome or pattern that substantially limits the
functioning of the person with the illness, including but not limited to, schizophrenia,
schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other
psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental
disorder or autism. "Same terms and conditions" means that the medical service corporation
cannot apply different copayments, deductibles or benefit limits to biologically-based mental
health benefits than those applied to other medical or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which a medical
service corporation determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the medical service corporation; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the contract.

c. The provisions of this section shall apply to all contracts in which the medical service
corporation has reserved the right to change the premium.

3.a. Every individual and group health service corporation contract that provides hospital or
medical expense benefits and is delivered, issued, executed or renewed in this State pursuant
to P.L.1985, c.236 (C.17:48E-1 et seq.), or approved for issuance or renewal in this State by the
Commissioner of Banking and Insurance, on or after the effective date of this act shall provide
coverage for biologically-based mental illness under the same terms and conditions as provided
for any other sickness under the contract. "Biologically-based mental illness" means a mental
or nervous condition that is caused by a biological disorder of the brain and results in a
clinically significant or psychological syndrome or pattern that substantially limits the
functioning of the person with the illness, including but not limited to, schizophrenia,
schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other
psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental
disorder or autism. "Same terms and conditions" means that the health service corporation
cannot apply different copayments, deductibles or benefit limits to biologically-based mental
health benefits than those applied to other medical or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which the health
service corporation determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the health service corporation; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the contract.

c. The provisions of this section shall apply to all contracts in which the health service
corporation has reserved the right to change the premium.

4. a. Every individual health insurance policy that provides hospital or medical expense
benefits and is delivered, issued, executed or renewed in this State pursuant to chapter 26 of
Title 17B of the New Jersey Statutes, or approved for issuance or renewal in this State by the
Commissioner of Banking and Insurance, on or after the effective date of this act shall provide
coverage for biologically-based mental illness under the same terms and conditions as provided
for any other sickness under the contract. "Biologically-based mental illness" means a mental
or nervous condition that is caused by a biological disorder of the brain and results in a
clinically significant or psychological syndrome or pattern that substantially limits the
functioning of the person with the illness, including but not limited to, schizophrenia,
schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other
psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental
disorder or autism ."Same terms and conditions" means that the insurer cannot apply different
copayments, deductibles or benefit limits to biologically-based mental health benefits than those
applied to other medical or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which the insurer
determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the insurer; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the policy.

c. The provisions of this section shall apply to all policies in which the insurer has reserved
the right to change the premium.

5. a. Every group health insurance policy that provides hospital or medical expense benefits
and is delivered, issued, executed or renewed in this State pursuant to chapter 27 of Title 17B
of the New Jersey Statutes, or approved for issuance or renewal in this State by the
Commissioner of Banking and Insurance, on or after the effective date of this act shall provide
benefits for biologically-based mental illness under the same terms and conditions as provided
for any other sickness under the policy. "Biologically-based mental illness" means a mental or
nervous condition that is caused by a biological disorder of the brain and results in a clinically
significant or psychological syndrome or pattern that substantially limits the functioning of the
person with the illness, including but not limited to, schizophrenia, schizoaffective disorder,
major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental disorder or autism. "Same
terms and conditions" means that the insurer cannot apply different copayments, deductibles or
benefit limits to biologically-based mental health benefits than those applied to other medical
or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which the insurer
determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the insurer; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the policy.

c. The provisions of this section shall apply to all policies in which the insurer has reserved
the right to change the premium.

6. a. Every individual health benefits plan that provides hospital or medical expense benefits
and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161
(C.17B:27A-2 et seq.) or approved for issuance or renewal in this State on or after the effective
date of this act shall provide benefits for biologically-based mental illness under the same terms
and conditions as provided for any other sickness under the health benefits plan. "Biologically-based mental illness" means a mental or nervous condition that is caused by a biological
disorder of the brain and results in a clinically significant or psychological syndrome or pattern
that substantially limits the functioning of the person with the illness, including but not limited
to, schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia
and other psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive
developmental disorder or autism. "Same terms and conditions" means that the plan cannot
apply different copayments, deductibles or benefit limits to biologically-based mental health
benefits than those applied to other medical or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which the carrier
determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the carrier; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the plan.

c. The provisions of this section shall apply to all health benefits plans in which the carrier
has reserved the right to change the premium.

7. a. Every small employer health benefits plan that provides hospital or medical expense
benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.162
(C.17B:27A-17 et seq.) or approved for issuance or renewal in this State on or after the effective
date of this act shall provide benefits for biologically-based mental illness under the same terms
and conditions as provided for any other sickness under the health benefits plan. " Biologically-based mental illness" means a mental or nervous condition that is caused by a biological
disorder of the brain and results in a clinically significant or psychological syndrome or pattern
that substantially limits the functioning of the person with the illness, including but not limited
to, schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia
and other psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive
developmental disorder or autism. "Same terms and conditions" means that the plan cannot
apply different copayments, deductibles or benefit limits to biologically-based mental health
benefits than those applied to other medical or surgical benefits.

b. Nothing in this section shall be construed to change the manner in which the carrier
determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the carrier; or

(2) which providers shall be entitled to reimbursement for providing services for mental
illness under the health benefits plan.

c. The provisions of this section shall apply to all health benefits plans in which the carrier
has reserved the right to change the premium.

8. a. Every enrollee agreement delivered, issued, executed or renewed in this State pursuant
to P.L.1973, c.337 (C.26:2J-1 et seq.) or approved for issuance or renewal in this State by the
Commissioner of Health and Senior Services, on or after the effective date of this act shall
provide health care services for biologically-based mental illness under the same terms and
conditions as provided for any other sickness under the agreement. "Biologically-based mental
illness" means a mental or nervous condition that is caused by a biological disorder of the brain
and results in a clinically significant or psychological syndrome or pattern that substantially
limits the functioning of the person with the illness, including but not limited to, schizophrenia,
schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other
psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental
disorder or autism. "Same terms and conditions" means that the health maintenance organization
cannot apply different copayments, deductibles or health care services limits to biologically-based mental health care services than those applied to other medical or surgical health care
services.

b. Nothing in this section shall be construed to change the manner in which a health
maintenance organization determines:

(1) whether a mental health care service meets the medical necessity standard as established
by the health maintenance organization; or

(2) which providers shall be entitled to reimbursement or to be participating providers, as
appropriate, for mental health services under the enrollee agreement.

c. The provisions of this section shall apply to enrollee agreements in which the health
maintenance organization has reserved the right to change the premium.

C.34:11A-15 Notification to employees of coverage for biologically-based mental illness.

9. An employer in this State who provides health benefits coverage to his employees or
their dependents for treatment ofbiologically-based mental illness shall annually, and upon
request of an employee at other times during the year, notify his employees whether the
employees' coverage for treatment of biologically-based mental illness is subject to the
requirements of this act.

10. This act shall take effect on the 90th day after enactment and shall apply to contracts,
policies and enrollee agreements issued or renewed on or after that date.